Disciplinary Action against Alireza Panahpour, D.D.S.

Stephen Barrett, M.D.

In 2005, as shown below, the Dental Board of California charged Alireza Panahpour, D.D.S. with negligently treating three teeth of a patient that needed restorations. The board also charged that he had improperly double-billed an insurance company and had used professional names other than the one under which he was licensed. The case was settled by a stipulation in which Panahpour admitted to using unlicensed names and gave up the right to contest the other charges. The board assessed him $10,000 for the cost of its proceedings and ordered him to serve two years' probation, during which he must take remedial courses in oral diagnosis and treatment planning. He is also barred from practicing as Dr. Alexander Pana or Dr. Alex Pana unless he legally changes his name.

1. Cynthia Gatlin (Complainant) brings this Accusation solely in her official capacity as the Executive Officer of the Dental Board of California, Department of Consumer Affairs (Board).

2. On or about April 21, 1994, the Board issued Dental License No. 41661 to Alireza Panahpour, D.D.S. also known as Alireza Panapour, Inc., Alexander Pana, D.D.S. Dr. Alex Pana, D.D.S., Dr. Pana and Eclectic Health (Respondent). The Dental License was in full force and effect at all times relevant to the charges brought herein and will expire on June 30, 2005, unless renewed.

JURISDICTION

3. This Accusation is brought before the Board, under the authority of the following laws. All section references are to the Business and Professions Code unless otherwise indicated ..

4. Section 1670 states:

"Any licentiate may have his license revoked or suspended or be reprimanded or be placed on probation by the board for unprofessional conduct, or incompetence, or gross negligence, or repeated acts of negligence in his or her profession, or for the issuance of a license by mistake, or for any other cause applicable to the licentiate provided in this chapter. The proceedings under this article shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein."

5. Section 1680 states, in pertinent part:

"Unprofessional conduct by a person licensed under this chapter [Chapter 4 (commencing with section 1600)] is defined as, but is not limited to, the violation of any one of the following:

"(a) The obtaining of any fee by fraud or misrepresentation.

"(f) The use of any false, assumed, or fictitious name, either as an individual, firm, corporation, or otherwise, or any name other than the name under which he or she is licensed to practice, in advertising or in any other manner indicating that he or she is practicing or will practice dentistry, except that name as is specified in a valid permit issued pursuant to Section 1701.5.

"(k) The advertising in violation of Section 651.

"(n) The violation of any of the provisions of this division .... "

6. Section 1685 states:

"In addition to other acts constituting unprofessional conduct under this chapter [chapter 4 (commencing with section 1600)], it is unprofessional conduct for a person licensed under this chapter to require, either directly or through an office policy, or knowingly permit the delivery of dental care that discourages necessary treatment or permits clearly excessive treatment, incompetent treatment, grossly negligent treatment, repeated negligent acts, or unnecessary treatment, as determined by the standard of practice in the community."

7. Section 651 states, in pertinent part:

"(a) It is unlawful for any person licensed under this division or under any initiative act referred to in this division to disseminate or cause to be disseminated any form of public communication containing a false, fraudulent, misleading, or deceptive statement, claim, or image for the purpose of or likely to induce, directly or indirectly, the rendering of professional services or furnishing of products in connection with the professional practice or business for which he or she is licensed. A "public communication" as used in this section includes, but is not limited to, communication by means of mail, television, radio, motion picture, newspaper, book, list or directory of healing arts practitioners, Internet, or other electronic communication.

"(b) A false, fraudulent, misleading, or deceptive statement, claim, or image includes a statement or claim that does any of the following: "

(1) Contains a misrepresentation of fact.

"(2) Is likely to mislead or deceive because of a failure to disclose material facts. "

"(3)(A) Is intended or is likely to create false or unjustified expectations of
favorable results, including the use of any photograph or other image that does not accurately depict the results of the procedure being advertised or that has been altered in any manner from the image of the actual subject depicted in the photograph or image.

"(B) Use of any photograph or other image of a model without clearly stating in a prominent location in easily readable type the fact that the photograph or image is of a model is a violation of subdivision (a). For purposes of this paragraph, a model is anyone other than an actual patient, who has undergone the procedure being advertised, of the licensee who is advertising for his or her services.

"(C) Use of any photograph or other image of an actual patient that depicts or purports to depict the results of any procedure, or presents "before" and "after" views of a patient, without specifying in a prominent location in easily readable type size what procedures were performed on that patient is a violation of subdivision (a). Any "before" and "after" views (i) shall be comparable in presentation so that the results are not distorted by favorable poses, lighting, or other features of presentation, and (ii) shall contain a statement that the same "before" and "after" results may not occur for all patients.

"(4) Relates to fees, other than a standard consultation fee or a range of fees for specific types of services, without fully and specifically disclosing all variables and other material factors.

"(5) Contains other representations or implications that in reasonable probability will cause an ordinarily prudent person to misunderstand or be deceived.

"(6) Makes a claim either of professional superiority or of performing services in a superior manner, unless that claim is relevant to the service being performed and can be substantiated with objective scientific evidence.

"(7) Makes a scientific claim that cannot be substantiated by reliable, peer reviewed, published scientific studies.

"(8) Includes any statement, endorsement, or testimonial that is likely to mislead or deceive because of a failure to disclose material facts .... "

8. , Section 125.3, subdivision (a), states, in pertinent part:

"Except as otherwise provided by law, in any order issued in resolution of a disciplinary proceeding before any board within the department . . the board may request the administrative law judge to direct a licentiate found to have committed a violation or violations of the licensing act to pay a sum not to exceed the reasonable costs of the investigation and enforcement of the case."

FIRST CAUSE FOR DISCIPLINE
(Incompetence, Gross Negligence and Repeated Acts of Negligence)

9. Respondent is subject to disciplinary action under section 1670, in that
Respondent committed acts of unprofessional conduct, incompetence, gross negligence and , repeated acts of negligence in his profession as a dentist through the restorative treatment performed on at least three of client L.H.'s teeth (#s 18, 19 & 30) which was below the commonly accepted standard of care and of poor quality in general, as set forth· above in paragraph 10.

FACTUAL CLIENT L.H.

10. ' On or between June 1998 and September 18, 2002, client L.H. regularly visited Respondent for dental services, and in regard to her teeth #18, #19 and #30, she experienced the following:

Tooth #18

a.. On or about November 30, 2001, Respondent performed and submitted for billing an inlay/onlay for tooth #18.

b. On or about July 25, 2002, client L.H. was diagnosed by another dentist that the porcelain inlay on tooth #18 was defective and decayed at the mesial gingival margin.

c. On or about September. 19, 2002, client L.H. had a root canal performed on tooth # 18 by another dentist.

d. On or about October 23, 2002, client L.H. had a permanent cast restoration placed on tooth #18 by another dentist.

Tooth #19

e. On or about March 1999, Respondent performed and submitted for billing a crown for tooth # 19

f. On or about March 13, 1999, client L.H. had a root canal performed on tooth # 19 by another dentist.

g. ' On or about August 2000, Respondent submitted a billing for a crown on tooth #19 and states to the insurance company that this tooth is sensitive and "patient needs a new crown to prevent irreversible pulpitis and root canal treatment."

h. On or about July 25, 2002, client L.H. was diagnosed by another dentist that the crown on tooth #19 had open margins and was in need of replacement.

i. On or about November 21, 2002, client L.H. had a permanent cast restoration placed on tooth #19 by another dentist.

Tooth #30

j. On or about July 14, 1998, Respondent performed and submitted for billing an indirect pulp cap/amalgam for tooth #30.

k. On or about August 2, 1999, Respondent performed and submitted for billing an indirect pulp cap/amalgam for tooth #30.

1. On or about July 18, 2000, Respondent performed and submitted for billing a crown for tooth #30.

m. On or about July 25, 2002, client L.H. was diagnosed by another dentist that the crown on tooth #30 had open margins and was in need of replacement.

n. On or about October 9, 2002, client L.H. had a root canal performed on tooth #30 by another dentist.

o. On or about November 5, 2002, client L.H. had a permanent cast restoration placed on tooth #30 by another dentist.

Aetna Life Insurance

p. On or about October 4, 2002, after committee review of client L.H.'s dental records and second opinions by another dentist, the Grievance and Appeal Department of Aetna Life Insurance Company (Aetna) issued a letter in regard to their findings relating to replacement of crowns on teeth #19 and #30, and replacement of the inlay on tooth #18, due to open margins and active decay after Respondent's treatment, as follows:

q. Aetna found that the crowns on teeth #19 and #30 need to be replaced due to open margins and active decay.

r. Aetna found that the inlay on tooth #18 needed to be replaced by a crown restoration.

s. Aetna indicates that Respondent chose to provide only a composite restoration on tooth #18 when he should have provided a root canal followed by a crown restoration.

t. Respondent was directed by Aetna to issue to client L.H. a full refund in
the amount of $503.53, which was the amount client L.H. paid to Respondent toward the treatment.

u. Aetna requested a refund in the amount of $704.30 as their portion of the
plan paid towards client L.H.'s prior treatment on teeth #18, #19 and #30 by Respondent.

Records

v. On or about October 9, 2003, the Board received from Respondent
duplicate and incomplete records for his treatment of client L.H. from on or between June 1998 and September 18, 2002.

SECOND CAUSE FOR DISCIPLINE
(Unlicensed Namestyles)

11. Respondent is subject to disciplinary action under section 1670, as defined
in section 1680, subdivision (f) and (k), in that Respondent used the false, assumed, or fictitious names of Alireza Panapour, Inc., Alexander Pana, D.D.S., Dr. Alex Pana, D.D.S., Dr. Pana and Eclectic Health, namestyles other than the name under which he is licensed to practice

THIRD CAUSE FOR DISCIPLINE
(False, Fraudulent or Misleading Statements)

12. Respondent is subject to disciplinary action under section 1670, as defined in section 1680, subdivision (n), in conjunction with section 651, in that for client L.H. Respondent misrepresented statements of fact to mislead or deceived others when he

a. Used namestyles other that under which he was licensed, as set forth above in paragraph 9,

b. Submitted dental claims to insurance companies for payment more than once for the same dental procedures, as set forth above in paragraph 10.

c. Requested the payment of services based upon a scientific claim which cannot be substantiated by reliable peer reviewed, published scientific studies, as set forth above in paragraph 10, and more specifically subdivision (g).

FOURTH CAUSE FOR DISCIPLINE
(Obtaining Fees by Misrepresentation)

13. Respondent is subject to disciplinary action under section 1670, as defined in section 1680, subdivision (a), in that for client L.H. Respondent obtained fees by fraud or misrepresentation, as set forth above in paragraph 10.

FIFTH CAUSE FOR DISCIPLINE
(Unprofessional Conduct)

14. Respondent is subject to disciplinary action under section 1670, as defined in section 1685, on the grounds of unprofessional conduct, in that Respondent committed acts which discouraged necessary treatment or permitted excessive treatment, incompetent treatment, grossly negligent treatment, repeated negligent acts, unnecessary treatment, and performing services below a licensed dentist's Standard of Care, failed to keep clear, legible and complete dental treatment records, and failed to comply with requests by the Board for a full and complete Dental Treatment Record on patient L.H., as set forth above in paragraphs 9 through 13, inclusive.

PRAYER

\VHEREFORE, Complainant requests that a hearing be held on the matters herein alleged, and that following the hearing, the Dental Board of California issue a decision:

2. Ordering Alireza Panahpour, D.D.S. to pay the Dental Board of California the reasonable costs of the investigation and enforcement of this case, pursuant to Business and Professions Code section 125.3;

3. Taking such other and further action as deemed necessary and proper.